There are several different systems that can be used for staging malignant mesothelioma, which explain how advanced the cancer is. Mesothelioma is usually diagnosed in a later stage.

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Malignant mesothelioma is a very rare type of cancer. It strikes the lining of many organs in the body, but about 75 percent of the time, it's found in the lining of the lungs. Mesothelioma is usually caused by exposure to asbestos, and typically causes symptoms like coughing and shortness of breath. Once a diagnosis is made, a doctor will "stage" the cancer. Staging tells how advanced the cancer is, and how treatment should proceed.

Mesothelioma: Cancer Staging Systems

Most types of cancer are staged using similar criteria, which designate how far the cancer has spread. Staging also takes into account how big the tumors are, how many there are, where they are located, and what types of cancer cells are present.

One common staging system for mesothelioma is called the Butchart System, which bases stages on the size and location of the primary tumor. Another system that is rarely used bases the stages on how easily the tumor can be surgically removed, and if the lymph nodes are affected. This is called the Brigham System.

One of the most comprehensive staging methods considers three factors: the tumor, the involvement of lymph nodes, and the presence of any metastases. This is called the TNM staging system.

Mesothelioma: Stages of Mesothelioma

In general, cancer can be referred to as either localized, meaning it's only in the tissues in the area where it started; or advanced, meaning the cancer has spread to organs and areas throughout the body.

More specifically, using the TNM system, malignant mesotheliomas fall into one of the following stages:

Stage I. In this stage of malignant mesothelioma, the cancer is still early and not very advanced. The cancerous cells are only found in the pleural membranes lining the chest wall or the diaphragm on one side of the body. At this stage, there is no cancer affecting the lymph nodes or other organs in the body. Mesothelioma is very rarely diagnosed in this stage because the warning signs are often not obvious.

Stage II. This stage means that in addition to involving the pleural membrane of the chest wall, the cancer has spread to the pleura lining of the lung on the same side, or into the lung or diaphragm itself. The lymph nodes in the area are not involved.

Stage III. The cancer may now affect the pleura of the chest wall, the pleura of the diaphragm or lung, and the actual lung. At this stage, the cancer may have also spread deeper into the chest wall, or into the outer membranes lining the heart. By stage III, mesothelioma often affects the lymph nodes, but not organs elsewhere in the body.

Stage IV. Size, location, and number of tumors can be in various combinations in stage IV malignant mesothelioma. At this stage, the cancer has spread more deeply into the layers of the chest wall, perhaps even into the muscles and ribs. It can penetrate the diaphragm, organs inside the mediastinum (area between the lungs that contains the heart, esophagus, and lymph nodes), the spine, and perhaps the pleural lining across the entire chest. Mesothelioma cells may even affect the heart muscle at this stage. It often involves the pleural lining on both sides of the chest. The tumor can be small or large, and cells may have spread to lymph nodes, organs, and sites more distantly throughout the body.

As with any cancer, the earlier mesothelioma is diagnosed, the better the prognosis and treatment options. There can be a different prognosis and treatment plan depending on the variations of tumor spread within each stage. A doctor should give a clear explanation of the factors used to designate the stage, and be clear about what parts of the body are being affected — and how the cancer can be treated.

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